Cardiovascular Disease Case Study

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1. INTRODUCTION Cardiovascular Diseases (CVD) were the second leading cause of death in 2013 in Singapore at 30.4%.1 With numerous established Cardiovascular Risk Factors (CVRFs) and appropriate management guidelines, more can be done to alter the disease progression and reduce complications and mortality due to CVD. In this study, we will focus on Acute Coronary Syndrome (ACS), which is a class of CVD that occurs when the blood supplied to the heart muscle is decreased or blocked, leading to heart attack,2 a medical emergency that can lead to death. ACS includes ST-elevated Myocardial Infarction (STEMI), Non-ST-elevated Myocardial Infarction (NSTEMI) and Unstable Angina (UA) which we would look at in totality in this study. Apart from the…show more content…
Clinic sessions run on Tuesday mornings (10am-1pm) and Wednesday afternoons (2pm-5pm) every week with each session having 8 to 14 patients. The goal of CPC includes managing CVRF for ACS patients, optimize medications for heart failure patients and manage complex patients on anticoagulation therapy. Since most of CPC’s patient load were ACS patient and that different CVD have different CVRFs and goals, this study would focus only on ACS patients. With regards to ACS, CPC admits ACS patients that have other risk factors complicating their disease and management to control patient load. Such factors include diabetes, renal impairment, non-compliance, poor ejection fraction and having more than 8 chronic…show more content…
The abstracted data included age, gender, race and type of ACS. To compare the severity of the patient’s cardiac condition at baseline, information on Ejection Fraction and the number and type of stent were also collected. To specifically evaluate the severity of ACS, GRACE (Global Registry of Acute Cardiac Events) Risk Prediction Index (GRPI) and corresponding mortality rate were collect.15 GRPI is a validated score that risk stratifies and estimates the admission to 6 month mortality for patients with ACS.16,17 It was further complemented with age-adjusted Charlson’s Comorbidity Index (CCI) and relative risk of death since there was a study showing it complement GRPI prediction.18-20 Data on the number of chronic diseases, number of chronic medications, total daily dose, frequency and duration of hospital admissions within the one year prior FV were also collected to provide a clearer picture on patients’ clinical

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